| Objective There is a consensus that major pathological changes of chronic atrophic gastritis are deficient nature and excessive manifestation of disease.And weakness of the spleen and stomach is important part of that.The conclusion that main syndrome elements with deficient characteristics of CAG were "qi-deficiency" and "yang-deficiency" based on tutor’s precious studies.Gastric mucosal biopsy is the golden standard for the diagnosis of chronic atrophic gastritis.Therefore,this study focused on distribution of the "qi-deficiency" and "yang-deficiency" in different gastric mucosal pathological changes,trying to find out the link between gastric mucosal pathological changes and CAG’s main syndrome elements.So as to provide reference for the clinical diagnosis and treatment of CAG in traditional Chinese medicine(TCM).Methods The subject chose 120 CAG cases from January 2019 to January 2020.Endoscope and pathological examination of all the cases met CAG diagnosis criteria and the cases all had different clinical manifestations.The CAG patients were divided into 5 groups by gastric mucosal pathological changes,including non-IM group(0),mild IM group(+),medium IM group(++),severe IM group(+++)and IN group.“Four Diagnosis” information was gathered through questionnaire first,and then typed into syndrome element differentiation system to find out integrals of "qi-deficiency" and "yang-deficiency" in cases.The integrals of syndrome elements were divided into three levels(mild,medium and severe level).And information of clinical manifestations and syndrome element’s distribution was analyzed statistically.Results 1.There was no significant differences(P>0.05)in gender and age distribution of CAG in different pathological changes of gastric mucosa.2.The syndrome element’s distribution of 120 cases:the frequency of stomach,spleen,liver and kidney accounts for half of totality as the primary syndrome elements of disease location,followed by gallbladder(20.83%),heart(20.00%),large intestine(16.67%),small intestine(15.83%),mind(15.00%)a-nd lung(15.00%).The primary syndrome elements of disease nature were qi-stagnation,qi-deficiency,dampness,yang-deficiency and phlegm,followed by yin-deficiency,blood-deficiency,heat,food accumulation,blood stasis and cold.There were differences in distributions between every syndrome element with various grades.(P<0.05)3.The pathological progress of gastric mucosa was positively correlated with "qi-deficiency" and "yang-deficiency"(r=0.430,0.249 were all>0,P<0.05),and there was a grade correlation(P<0.05).4."Qi-deficiency" and "yang-deficiency" were important factors in the stage of non-IM and mild IM(P<0.05,OR <1)."Yang-deficiency" was a risk factor in medium and severe IM(P<0.05,OR=1.701>1),while "qi-deficiency" was neither important factor nor risk factor. "Qi-deficiency" and "yang-deficiency" were not risk factors in the stage of IN(P>0.05).5.Spleen and kidney were also risk factors in the pathological progress of gastric mucosa(P<0.05,OR>1)."Qi-deficiency" and "yang-deficiency" were related to spleen and kidney(P<0.05).According to the order of correlation coefficient: spleen qi-deficiency(r=0.487)>kidney qi-deficiency(r=0.379),kidney yang-deficiency(r=0.459)>spleen yang-deficiency(r=0.455).Conclusion 1.The different pathological progress of gastric mucosa in CAG is characterized by qi-deficiency and yang-deficiency.The deficiency of qi and Yang gets more severe while the pathological deterioration of gastric mucosa.2.Qi-deficiency and yang-deficiency can be observed in IN,but main part of pathologic changes is more complicated,which is characteristic of mixture of deficiency and excess.3.Qi-deficiency and yang-deficiency in CAG are related to spleen and kidney.Non-IM or mild IM is mainly due to spleen qi-deficiency while medium IM or severe IM is mainly due to spleen and kidney yang-deficiency. |
